Review concludes Nottingham hospital trust's response to patient letters failure ‘was appropriate’

Nottingham University Hospitals (NUH) launched a ‘serious incident investigation’ in 2017 after discovering 411,000 digital documents on an internal system called Medical Office were never sent.

Medical Office is a paperless system for typing up letters.

Of the total, around 22,000 were found to be ‘high risk’ and intended for GPs, but had not been sent out because they had not been marked as authorised.

The trust said a full investigation took place in 2017 and found no significant harm to patients.

The investigation went back 20 years to 1997.

In November 2023 the trust agreed to review its original investigation to ‘offer reassurance to the public’.

Now, the latest review has concluded: “There is assurance that the approach taken to the 411,598 documents discovered, of which 22,135 were identified as GP correspondence, in the Medical Office software was appropriate and sufficiently assessed patient risk.”

The review was discussed at a trust board meeting on January 11.

Medical Office is a software programme which stores documents while they are waiting to be sent out or stored.

In September 2023, NUH said it would carry out a review of that investigation and take any further action needed.

Medical director Keith Girling was part of the review and said no patient safety issues were identified.

He continued: “A small group of us looked back at the documents that are currently available in Medical Office.

“Thousands of documents are created in Medical Office every day.

“Of the documents that were not authorised, we look at clinical risks, and there were no patient safety issues identified.

“There were patient inconvenience issues because the majority were appointments that should’ve been sent out to patients.”

Speaking during the board meeting, Mark Chivers, non-executive director, said the organisation’s audit committee, which he chairs, was not made aware of the new review.

He said: “Audit committee hasn’t seen this and that felt like an audit committee conversation.

“It feels a bit of a strange conversation that it has come straight to board and you’ve done all the work.”

Anthony May, chief executive, replied: “It is a very fair point, my apologies to you.

“I commissioned this review in response to the media enquiries which identified the need to go back and satisfy ourselves and the public that we had done a thorough job of this in 2017.

“I should’ve notified you and we should’ve taken your steer.”

Nick Carver, trust chair, said: “We haven’t followed an appropriate process ourselves,.

"Anthony has been very clear about that and accepted responsibility for that.”